Report #2904985

Received Jul 28, 2026

Office visit

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Female
Age: 83 yrs
State: MI
Recovered: Not recovered
Vaccinated: Nov 3, 2025
Onset: Nov 1, 2025
Days to onset: —
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	7+	3053483	IM / RA

Symptoms (1)

Mouth ulceration

Symptom narrative

PT IS EXPERIENCING ORAL ULCERS SINCE RECEIVING THE VACCINE.

Current illness

Nothing

Medical history

afib, melanoma, hypothyroidism

Other medications

Eliquis, Pravastatin, levoxyl, clobetasol, d3, magnesium 250mg, 500mg vit c, b complex, meletonin, citrical plus d, glutein zx

Allergies

Nortriptyline

Lab data

N/A

Prior vaccinations

SHE GETS A RED ARM SOMETIMES.